New research from the European Society of Cardiology shows women over 55 with clogged arteries are at a higher risk for heart attacks than their male counterparts. Postmenopausal women with plaque buildup in their arteries are more likely to experience a cardiovascular event than men of the same age group. The study suggests that a given burden of atherosclerosis is riskier in women than men of that age. Researchers examined whether or not the presence of atherosclerosis had the same importance in prognosis for men and women of the same age. They found there was a 12-year delay in the onset of coronary atherosclerosis in women. The presence of plaque was found to be equally predictive of a major adverse cardiovascular event in men and women aged under 55. However, in women who were 55 and older and in the postmenopausal group, the risk of an adverse cardiovascular event was higher than in men in the same age group. Among postmenopausal women, those with a medium or high plaque burden had a 2.21 to 6.11-fold higher risk of a major adverse cardiovascular event.
The study involved nearly 25,000 people across six countries in North America, Europe, and Asia. An imaging technique called coronary computed tomography angiography (CCTA) was used to capture 3D images of the arteries in the heart. Atherosclerosis is when the arteries narrow due to a build of sticky deposits of plaque. In the United States, it’s estimated that about half of people between the ages of 45 and 84 have atherosclerosis and don’t know it. Heart disease, which is associated with atherosclerosis, is the leading cause of death in the United States.
Dr. Abha Khandelwal, a clinical associate professor of cardiovascular medicine at Stanford University in California, who wasn’t involved in the study, said these findings aren’t surprising. “Clinically, what we see is there’s a whole host of changes that occur around menopause and several of them are significantly impactful to the cardiometabolic status of a woman. So. it is very common that women will have derangements in their blood pressure, blood sugar, cholesterol, weight, all around the time of menopause. So I always ask my patients to be reassessed around that time.”
Clinicians recommend there are several options women can take before menopause to protect their cardiovascular health. At all ages of life, there’s an opportunity for each patient to work with their doctor to maximize a healthy lifestyle, to screen for atherosclerosis, or this sticky plaque build-up, and to screen for the risk factors that cause atherosclerosis. These include high blood pressure, high cholesterol, diabetes, smoking, family history, vasculitis (inflammation of the blood vessels), and certain autoimmune conditions. Women can treat these conditions proactively to prevent future cardiovascular issues.
Dr. Sarina van der Zee, a cardiac electrophysiologist and cardiologist at Providence Saint John’s Health Center in California, believes preventative options can be identified and treated early on in partnership with a woman’s doctor. “So absolutely there are preventative options that a woman with her doctor can identify, treat upstream and prevent from coming becoming an issue. This is especially important after menopause, but certainly is an important process to start even beforehand, if possible,” she added.
Experts suggest common steps for women to take to maintain cardiovascular health include maintaining healthy blood pressure and cholesterol levels while not smoking. These steps are crucial for protecting the heart, especially after menopause when changes to a woman’s cardiometabolic status can occur.
